Apparatus for washing patients
hygienicaixy

ABSTRACT

1. APPARATUS FOR WASHING PATIENTS HYGIENICALLY WITH MINIMUM DISTURBANCE OF THE PATIENT COMPRISING A CLOSED CONTAINER FOR A WASHING LIQUID CONTAINING A SMALL AMOUNT OF A SURFACE-ACTIVE AGENT, MEANS FOR COMPRESSING AIR, MEANS FOR SUPPLYING COMPRESSED AIR FROM SAID COMPRESSOR MEANS TO SAID CLOSED CONTAINER IN AN ATOMIZED STATE TO FORM A CLEANSING FOAM OF THE WASHING LIQUID, AT LEAST ONE APPLICATION NOZZLE HAVING AT LEAST ONE OUTLET PORT (PORTS) AND AT LEAST ONE SUCTION PORT (PORTS), TWO FLEXIBLE TUBULAR ELEMENTS, ONE OF SAID TUBULAR ELEMENTS CONNECTING THE OUTLET PORTS OF SAID AT LEAST ONE NOZZLE TO SAID CLOSE CONTAINER FOR SUPPLYING FOAM UNDER PRESSURE TO THE OUTLET PORTS OF SAID NOZZLE FOR APPLICATION OF CLEANSING FOAM TO THE PATIENT&#39;&#39;S SKIN, MEANS FOR CREATING (OF) SUCTION, A CLOSED COLLECTING CONTAINER, SAID SECOND TUBULAR ELEMENT CONNECTING THE SUCTION PORTS OF SAID AT LEAST ONE NOZZLE TO THE SUCTION-CREATING MEANS FOR WITHDRAWING THE CLEANSING FOAM FROM THE SKIN AND PASSING IT TO THE CLOSED COLLECTING CONTAINER WHERE THE FOAM DISINTEGRATES, MEANS FOR WITHDRAWING AT A PREDETERMINED PRESSURE THE GASES LIBERATED IN SAID CLOSED COLLECTING CONTAINER AND MEANS FOR HEAT CLEANING SAID WITHDRAWN GASES AND MEANS FOR WITHDRAWING THE LIQUID FROM SAID COLLECTING CONTAINER.

May 6, 1975 SQLLERUD Re. 28,405

APPARATUS FOR WASHING PATIENTS HYGIENICALLY Original Filed Dec. 26, 1968United States Patent Re. 28,405 Reissued May 6, 1975 28,405 APPARATUSFOR WASHING PATIENTS HYGIENICALLY Soren Snllerud, Norrkoping, Sweden,assignor to Svenska Utvecklingsaktiebolaget, Stockholm, Sweden OriginalNo. 3,574,239, dated Apr. 13, 1971, Ser. No. 786,988, Dec. 26, 1968.Application for reissue Nov. 9, 1972, Ser. No. 305,001 Claims priority,application Sweden, Jan. 12, 1968, 448/68 Int. Cl. A47k 7/00, 17/00 US.Cl. 4-1 20 Claims Matter enclosed in heavy brackets appears in theoriginal patent but forms no part of this reissue specification; matterprinted in italics indicates the additions made by reissue.

ABSTRACT OF THE DISCLOSURE The invention concerns apparatus for bathinga bedridden patient whereby washing medium continuously is suppliedcentrally through a pressure nozzle and after its use is sucked offperipherally through a suction nozzle arranged about the pressurenozzle.

This invention relates to a cleaning method and arrangement andparticularly to a method and arrangement for cleaning surfaces.

It has always been a problem to wash surfaces, which are difficult toaccess or sensitive. This problem, however, was particularly great inhospitals and similar places with concern to patients who are bedriddenor have a restricted power of motion.

It is generally known that of the three usual bodycleaning methods:washing, bathing and douching, the last-mentioned method is to berecommended most from a hygienic point of View. In nursing, however,where the hygiene requirements are particularly high, this method hasproved not only difiicult but even impossible to be applied to bedriddenpatients. The possibilities available today for washing of patientsconfined to their beds are restricted to the use of washing flannels orbath sponges, which are dampened in water to which soap or anotherdetergent has been added, followed by drying with a towel. Thedisadvantages of this kind of washing are obvious, both as regards theresult and with respect to hygiene, particularly when it concernspatients suffering from spontaneous intestinal secretions. 'For thestaff this method is awkward, time consuming and unaesthetic, and inmany cases it constitutes an obstruction to the recruiting of labour forthese nursing professions.

In hospitals for infectious diseases and in other nursing sectionsinvolving great risks of infection one tries to isolate the infection byproviding a bathroom and water closet for the individual patient. It isdesired to burn up all refuse from such nursing places. This is possibleas far as bladder and intestinal secretions are concerned which can becollected in plastic bags filled with wood dust or the like. Such amethod is troublesome and at times even impossible to be carried outwhen it refers to used bath or washing water. Moreover, from a dischargetechnical point of view the bathtub propides a protection which is mostineffective against micro-organic return flow.

Sterilization of water in necessary quantities, or the supply andstorage of fresh water, for obtaining a fully satisfactory hygiene, ifthese measures are taken at all, involve considerable investments ofmaterial and personnel.

The aforementioned drawbacks and deficiencies with concern to hygienecan be doubled many times over, and all of them also can be eliminatedif the water traps and sewer were not restricted to their place, furtherif the water flow could be controlled so as only to be brought intocontact with the place to be washed, if the water volume could bereduced to the small percentage of molecules, which really are active inthe cleaning process, and if the cleaning process could be carried outwithout manual contact with the soiled place.

The present invention has as its objects to eliminate the shortcomingsinvolved in the present washing methods.

The invention relates to a method of washing bedridden patients in aneasy, quick and lenient manner, and it is characterized in that awashing medium of originally small volume is made voluminous and iscontinuously supplied locally to the skin of the patient where it actsfor a short time, and is removed for disinfection together withimpurities washed off.

The invention also includes an arrangement for carrying out the method,which arrangement substantially is characterized by a compressor, awashing medium preparing apparatus, a suction pump, a collecting vesselfor used washing medium and a combined pressure and suction nozzle.

Washing or douching under running water, which continuously is renewed,was taken as a pattern for the design of the present invention, which isbased on the principle of generating the washing medium to such a form,that both the washing medium and its localization when being applied canbe controlled. This can be achieved, for example, by addingsurface-active substances to the water in a closed vessel and thereafterby filtered compressed air to effect a foam of suitable density andduration.

By directing the. prepared foam directly from the generator t0 the zonein question on the patients body, via a flexible hose provided with anexchangeable end nozzle of, for example, foamed plastic, the greatestpossible protection against infection by the washing medium is obtained.In the immediate vicinity of or concentrically with the washing nozzlean exchangeable suction nozzle is mounted which preferably can be madeof foamed plastic, whereby it is possible with one and the same motionto supply the washing medium, to wash and to suck up used washingmedium. As a complement a special foam-wetted suction hose of greaterdimension is provided for sucking up possible intestinal secretions,vomitings etc.

The invention is described in greater detail in the following, withreference to the accompanying drawing showing an embodiment of thearrangement according to the invention.

FIG. 1 shows a schematic view of the arrangement according to thepresent invention.

FIG. 2 shows in principle how the arrangement is applied.

In a cart 1 an electric compressor 2 is mounted and provided with abacteria filter 3 for the input air, which subsequent to its compressionvia a pipe 4 is directed out through an atomizing nozzle 5 into a liquidvessel 6 containing a solution of, for example, 99 percent water and 1percent surface-active substance. The airflow gives rise to theformation of foam, which via a hose 7 is pressed out through a nozzle 8provided with an exchangeable bath sponge 9. The nozzle 8 includes aconcentric passageway extending about the bath sponge 9 the outer edgeof which is provided with an exchangeable ring 10 of air-permeablefoamed plastic. The concentric passageway communicates via a hose 11, athree-way valve 12 and a safety valve 13 with an electric vacuum pump14, which on its pressure side is connected with a pressure container 15provided with an outlet valve 16 and a spring-loaded valve 17,

which opens at an overpressure of approximately one at-.

mosphere whereafter the discharged air is urged to pass through acleaner 18 consisting of an electric filament spiral. The aforementionedthree-way valve 12 can, it required, be adjusted so as to connect apipe-connecting piece 19 with the vacuum pump 14, instead of the suctionpassageway in the washing nozzle 8. Said connecting piece 19 comprisesan upright connection to the three-way valve and a laterally directedconnection to a hose 20, and, besides, it is formed on its lower surfaceso as to provide a holding portion for a detachable container 21 oftransparent material. The hose 20 is connected to a suction nozzle 22,which is provided with an exchangeable contact safety device 23 ofnonrigid plastic, and which, besides, is provided with recesses for theinlet of air in order not to impede the airflow, and also with holescorresponding to passageways arranged in the suction nozzle 22, whichpassageways via a hose 24 are connected to the vessel 6 and hose 7through the valve 25. The pipe connection 19-23 is intended for suckingup intestinal secretions, vomitings etc.

A patient lying in bed is washed in the manner as follows. After thewashing medium (the surface-activated water) has been filled in andwashing agent as well as possibly other agents desired for the patienthave been added, the apparatus is moved to the patient where it isconnected to an electric wall socket and prepared with new or cleanednozzles and sponges. Thereafter the patient is uncovered. If the patientis found to be heavily soiled by evacuations from the bowel or of othertype, first this coarse substance is removed by the evacuation suctionnozzle 22, after the three-way valves 12 and 25 had been adjusted tosucking action and foam supply, respectively, in said [nozzled] nozzle,whereby also highly adhesive impurities can be sucked up and transportedvia the hose 20 to the container 21. Thereafter the three-way valves 12and 25 are adjusted to sucking action and foam supply, respectively, inthe nozzle 8, and the washing procedure is commenced. The nurse washesthe patient from the head downwards, and by alternatingly starting andstopping both the compressor and the vacuum pump the nurse can controlthe supply of foam as well as the time for washing by using the sponge.

From 3 litres of surface-activated water approximately 60 litres foamare obtained which, after it was sucked up and compressed in a pressurecontainer 15, is given a volume of approximately 15 litres. A quantityof approximately 3 litres foam is sutficient for washing a patientsoiled to an average extent.

The safety valve 13 is set for a vacuum limit, which is of no danger tothe patient, and it starts operation when the ring or the contact safetydevice 23 for some reason does not allow air to pass through.

Other embodiments of the invention can be imagined without abandoningthe idea of the invention, such as stationary installations withconnections for washing medium and vacuum located near the patients bed,and systems with entirely separated washing and suction nozzles.

To the washing medium may also be added antiseptic or other agentsrecommended by a physician. The design of the invention also allows formedical treatment possibilities where the physician individually canprescribe a therapeutic agent to be added to the washing medium. Theliquid vessel 6 of the apparatus is provided with inlet ducts formedical additives, and the collecting containers 15 and 21 are providedwith inlet ducts for disinfecting agents possibly added.

It is easy to realize the considerable advantages olfered by theinvention. The costs for washing a patient are substantially reducedboth due to the low costs of the generated washing medium and by thecapacity rendered possible by the invention. The washing procedureinvolves for the patient and the staff a social-ethical improvement,which has a favorable effect on the hardworking nursing staff. As aresult of the invention can be mentioned the possibility of reducing innursing the expensive nosocomial infections. The entire washingprocedure and the operation of the apparatus requires only one person,and the patient need not be lifted but has only to be turned on hisside, in which position the patient,

if necessary, can be supported during the washing procedure by a plasticcushion. As the apparatus operates substantially noiselessly, thepatients are not subjected to any disturbing noises. Owing to the largecapacity of the arrangements all patients, whether they are confined totheir beds or not, can be washed within the ward and, thus, the usualtime-consuming transport to the bathing department is no longernecessary.

, As a complement to the apparatus, a liquid-lubricated evacuationsucking device with a throwaway container for the collection ofevacuations can be mounted, and it also is possible to add to thewashing medium skin-stimulating agents, antiseptic or other agentsrecommended by a physician, which in combination with the carefulwashing according to this method render it possible also to washpatients who under other circumstances must be washed with cotton andspirits.

The effectiveness with respect to volume can be understood by acomparison between the three litres of washing medium and the resultingup to 800 litres of foam, depending on the density of the foam, which issufiicient for a total washing of patients soiled to an average extent.

The apparatus can also be provided with connections for Washing nozzleand evacuation sucking device, so that the entire apparatus can beflushed with a circulating disinfecting liquid.

Conclusively it may be mentioned, that the continuously increasing useof antibiotics in nursing enforces the production of increasinglyvigorous virus. Against these virus one tries to defend oneself, aboveall by using throwaway material to the greatest possible extent. It canbe safely assumed, therefore, that within a few years it will bedesirable to destroy after every washing both the washing nozzle and thehoses as well as the internal equipment in the vacuum pump. The economicpossibilities therefor are not insurmountable in connection with thearrangement according to the invention.

The invention though having been shown and described in connection withthe washing of bedridden patients is, of course, not restricted thereto.The invention is extremely well adapted [21.0. also] for the washing ofsurfaces with diflicult access, such as ceilings and wall sectionslocated at a greater height, in which case the washing nozzle can bemounted on a long rod or a pipe. The advantage offered by the inventionis obvious. The entire cleaning process is carried in one moment and thewashed surface section is left clean and dry or substantially dry. Nowashing sponges or brushes or running water or drying fiannels arerequired. The work itself is clean, easily and rapidly performed andrenders optimum results.

I claim:

- 1. Apparatus for washing patients hygienically with minimumdisturbance of the patient comprising a closed container for a washingliquid containing a small amount of a surface-active agent, means forcompressing air, means for supplying compressed air from said compressormeans to said closed container in an atomized state to form a cleansingfoam of the washing liquid, at least one application nozzle having atleast one outlet port [ports] and at least one suction port [ports], twoflexible tubular elements, one of said tubular elements connecting theoutlet ports of said at least one nozzle to said closed container forsupplying foam under pressure to the outlet ports of said nozzle forapplication of cleansing foam to the patients skin, means for creating[of] suction, a closed collecting container, said second tubular elementconnecting the suction ports of said at least one nozzle to thesuction-creating means for withdrawing the cleansing foam from the skinand passing it to the closed collecting container where the foamdisintegrates, means for withdrawing at a predetermined pressure thegases liberated in said closed collecting container and means for heatcleaning said withdrawn gases and means for withdrawing the liquid fromsaid collecting container.

2. Apparatus as claimed in claim 1 wherein the suction [outletj portsare arranged about the periphery of the outlet [suction] ports andfurther comprising a spongelike element disposed over the outlet portsfor controlling the application of foam to the skin.

3. Apparatus as claimed in claim 1 wherein the suction side of saidmeans for creating a suction is connected to the suction ports throughsaid second tubular element and the pressure side of said means isconnected to said collecting container.

4. Apparatus as claimed in claim 1 and further comprising a secondnozzle having outlet ports and suction ports, a three-way valve in saidfirst tubular element adjacent said closed container, means fordirecting foam from said valve to said second nozzle, a second three-wayvalve in said second tubular element adjacent said suction means, meansaffording communication between said second three-Way valve and saidsecond nozzle, whereby said three-way valves may establish communicationwith at least one of said two nozzles.

5. Apparatus as claimed in claim 1 wherein the suction ports arearranged around the periphery of the outlet ports and further comprisinga spongelike element disposed over the outlet ports, whereby theapplication of foam to the skin is controlled and the outer surface ofsaid sponge element serves as a washing means for the surface beingcleansed.

6. Apparatus as claimed in claim 5 and further comprising a ring ofspongelike material disposed about the periphery of the suction ports toprotect the skin area being cleansed and to assure substantiallycomplete removal of foam from the skin area.

7. Apparatus as claimed in claim 6 wherein the spongelike elementdisposed over the outlet ports and the spongelike element about theperiphery of the suction ports are formed as a single element which isremovably attached to the associated nozzle.

8. Apparatus for cleaning a patient hygienically with minimumdisturbance of the patient, comprising, in combination, supply containermeans for a washing medium compatible with human skin, a source ofpressurized gas, means for supplying pressurized gas from said source tosaid supply container means to pressurize washing medium containedtherein, collecting container means, suctioncreating means, conduitmeans connecting said suction creating means to said collectingcontainer means, at least one hand-manipulatable application nozzlehaving an exchangeable surface compatible withl a patients skin andadapted to overlie a localized area of the patients skin, said nozzlehaving orifice means communicating with said surface, and flexibletubular element means connecting said orifice means of said nozzle tosaid supply container means and to said suction-creating means in amanner to effect application of washing medium through said orificemeans to the patients skin and withdrawal of the washing medium from thepatients skin for passage to said collecting container means throughsaid conduit means.

9. Apparatus as defined in claim 8 wherein said orifice means comprisesat least one outlet port and a plurality of suction ports, said suctionports being arranged about the periphery of said outlet ports, saidexchangeable surface comprising a spongelike element disposed over saidoutlet ports for controlling the application of washing medium to thepatients skin.

10. Apparatus as claimed in claim 9, and further including a ring ofsponge-like material disposed about the periphery of said suction portsto protect the skin area being cleansed and to assure substantiallycomplete removal of washing medium from the skin area after dischargefrom said nozzle.

11. Apparatus as defined in claim 8 wherein said collector containermeans includes means for withdrawing at a predetermined pressure anygases liberated in said collector container, said collector containerfurther including means for withdrawing liquid contained therein.

12. Apparatus as defined in claim 8 including safety valve means forlimiting the suction applied against the patients skin through saidorifice means from said suctioncreating means.

13. Apparatus for cleaning a patient hygienically with minimumdisturbance of the patient, comprising, in combination, supply containermeans for a washing medium compatible with human skin, a source ofpressurized gas, means for supplying pressurized gas fromsaid source tosaid supply container means to pressurize washing medium containedtherein, collecting container means, suctioncreating means, conduitmeans connecting said suctioncreating means to said collecting containermeans, a first hand-manipulatable application nozzle having anexchangeable surface compatible with a patients skin and adapted tooverlie a localized area of the patients skin, said first nozzle havingorifice means communicating with said surface, flexible tubular elementmeans connecting said orifice means of said nozzle to said supplycontainer means and to said suction-creating means in a manner to efiectapplication of washing medium through said orifice means to the patientsskin and withdrawal of the washing medium from said patients skin forpassage to said collecting container means through said conduit means, asecond hland-manipulatable nozzle having outlet ports and suction ports,means including first flow control valve means for directing washingmedium from said supply container means to said outlet ports of saidsecond nozzle, and means including second flow control valve meansaflording communication between said suction-creating means and saidsuction ports of said second nozzle, said first and second valve meansbeing selectively operable toestablish communication between either ofsaid first and second nozzles and said supply and collecting containermeans.

14. Apparatus as defined in claim 13 wherein said washing mediumcomprises water containing a small amount of surface-active agent, andincluding means disposed within said supply container means foratomizing said pressurized gas supplied thereto to form a cleansing foamfor discharge through said orifice means 07 said first nozzle.

15. Apparatus as defined in claim 13, wherein said first and second flowcontrol valve means each comprises a three-way valve.

16. Apparatus as defined in claim 13 including additional collectingcontainer means connected in fluid communication with said suction portsof said second nozzle for receiving washing medium and matter carried therein after discharge from said second nozzle.

17. A system for washing patients hygienically with a minimumdisturbance of the patient, comprising, in combination, portable cartmeans moveable to positions generally adjacent patients to be washed,supply container means supported by said cart means for containing aquantity of a foamable washing medium, air pressure means supported bysaid cart means and connected in communication with the interior of saidsupply container means, collecting container means supported by saidcart means, hand-manipulatable nozzle means having an exchangeablesurface compatible with a patients skin and adapted to overlie alocalized area of the patients skin, said nozzle means having dischargeports and suction return ports, first conduit means connecting saiddischarge ports of said nozzle means to said supply container means,second conduit means connecting said suction return ports of said nozzlemeans to said collecting container means, suction-creating means incommunication with said suction return ports of said nozzle, said airpressure means being operable to efiect discharge of a cleansing foamfrom said nozzle for application to a patients skin, and said suctioncreating means being operable to efiect return of the cleansing foamthrough said suction return ports of said nozzle to said collectingcontainer means.

18. A system for washing patients hygienically with a minimumdisturbance o7 the patient, comprising, in combination, portable cartmeans movable to positions generally adjacent patients to be washed,supply container means supported by said cart means for containing aquantity of a foamable washing medium, air pressure means supported bysaid cart means and connected in communication with the interior of saidsupply container means, collecting container means supported by saidcart means, first hand-manipulatable nozzle means having at least onedischarge port and at least one suction return port, first conduit meansconnecting said discharge ports of said first nozzle means to saidsupply container means, second conduit means connecting said suctionreturn ports of said first nozzle to said collecting container means,suction creating means in communication with said suction return portsof said first nozzle means, said air pressure means being operable teflect discharge of a cleansing foam from said first nozzle means forapplication to a patients skin, said suction creating means beingoperable to efiect return of the cleansing foam through said suctionreturn ports of said first nozzle means to said collecting containermeans, second hand-manipulatable nozzle means having discharge ports andsuction re'turn ports connected, respectively, for fluid communicationwith said supply container means and said suction creating means, andvalve means operable to effect selective discharge of cleansing foamfrom said discharge ports of said second nozzle means for application toa patients skin and return of the discharged foam through said suctionreturn ports of said second nozzle means to said collecting containermeans.

19. Apparatus for cleaning a patient with minimum disturbance to thepatient, comprising, in combination, collectin g container means forreceiving extraneous substances from a patients skin, suction-creatingmeans, hand-manipulatable nozzle means having a hand grip portion andbeing lightweight and of sufiiciently small size to be carried in oneshand for selective movement in contact with a patients body, said nozzlemeans having an exchangeable surface area adapted to overlie a localizedarea of the patients skin, said nozzle means having orifice meanscommunicating with said surface area, said orifice means being of such asize as to allow inward flow therethrough of extraneous substancesincluding solid particles disposed on the patients skin being cleaned,and tubular element means interconnecting said suction-creating means,said collecting container means and said orifice means of said nozzlemeans in a manner to allow flow of extraneous matter from the patientsskin underlying said surface area of said nozzle means through saidtubular element means to said collecting container means, said surfacearea of said nozzle means being replaceable so as to allow presentationof a new surface area to each patient cleaned by said apparatus.

20. Apparatus for cleaning a patient with minimum disturbance of thepatient, comprising, in combination, supply container means for awashing medium compatible with human skin, a source of pressurized gas,means for supplying pressurized gas from said source to said supplycontainer means for pressurizing washing medium contained therein,collector container means, asource of subatmospheric pressure, firstnozzle means having orifice means through which pressurized washingmedium may be discharged onto and withdrawn from a patients skin, secondnozzle means having orifice means through which extraneous meatter onthe patients skin may be drawn, and flexible flow conduit meansconnected in communication with said supply container means, said sourceof subatmospheric pressure and said collector container means, saidconduit means being adapted for selective connection to said firstnozzle means to efiect discharge of pressurized washing medium onto apatients skin and withdraw said washing medium therefrom by suction forpassage to said collector container means, or connection to said secondnozzle means to withdraw extraneous matter from the patients skin bysuction and pass said matter to said collector container means.

References Cited The following references, cited by the Examiner, are ofrecord in the patented file of this patent or the original patent.

UNITED STATES PATENTS 2,885,713 5/1959 Morrill 15322 3,079,285 2/1963Rockwell 15321 2,999,258 9/1961 Berbel'ian 15321 1,929,345 10/1933 Brownet a1. 15321 3,089,790 5/1963 Balamuth et a1. 15321 3,121,896 2/1964Allen et a1. 15321 3,538,535 11/1970 Ginsburgh 15302 2,168,692 8/1939Vidal 15-320 1,451,437 4/1923 Bernier 4158 1,359,985 11/1920 Gromer 4158FOREIGN PATENTS 463,735 4/1937 Great Britain 1532l 449,826 1912 France1346 486,500 6/1938 Great Britain 13421 JOHN W. HUCKERT, PrimaryExaminer S. S. LEVY, Assistant Examiner US. Cl. X.R.

